ADDENDUM F:  DIAGNOSTIC IMAGING SERVICE SUBJECT									
TO THE MULTIPLE PROCEDURE PAYMENT REDUCTION FOR									
PC AND TC SERVICES  CY 2014 FINAL RULE									
Code	Short Descriptor								
70336	Magnetic Image, jaw joint								
70450	Ct head/brain w/o dye								
70460	Ct head/brain w/ dye								
70470	Ct head/brain w/o & w/ dye								
70480	Ct orbit/ear/fossa w/o dye								
70481	Ct orbit/ear/fossa w/ dye								
70482	Ct orbit/ear/fossa w/o & w/ dye								
70486	Ct maxillofacial w/o dye								
70487	Ct maxillofacial w/ dye								
70488	Ct maxillofacial w/o & w/ dye								
70490	Ct soft tissue neck w/o dye								
70491	Ct soft tissue neck w/ dye								
70492	Ct soft tissue neck w/o & w/ dye								
70496	Ct angiography, head								
70498	Ct angiography, neck								
70540	Mri orbit/face/neck w/o dye								
70542	Mri orbit/face/neck w/ dye								
70543	Mri orbit/face/neck w/o & w/dye								
70544	Mr angiography head w/o dye								
70545	Mr angiography head w/dye								
70546	Mr angiography head w/o & w/dye								
70547	Mr angiography neck w/o dye								
70548	Mr angiography neck w/dye								
70549	Mr angiography neck w/o & w/dye								
70551	Mri brain w/o dye								
70552	Mri brain w/dye								
70553	Mri brain w/o & w/dye								
70554	Fmri brain by tech								
71250	Ct thorax w/o dye								
71260	Ct thorax w/ dye								
71270	Ct thorax w/o & w/ dye								
71275	Ct angiography, chest								
71550	Mri chest w/o dye								
71551	Mri chest w/ dye								
71552	Mri chest w/o & w/ dye								
71555	Mri angio chest w/ or w/o dye								
72125	CT neck spine w/o dye								
72126	Ct neck spine w/dye								
72127	Ct neck spine w/o & w/dye								
72128	Ct chest spine w/o dye								
72129	Ct chest spine w/dye								
72130	Ct chest spine w/o & w/dye								
72131	Ct lumbar spine w/o dye								
72132	Ct lumbar spine w/dye								
72133	Ct lumbar spine w/o & w/dye								
72141	Mri neck spine w/o dye								
72142	Mri neck spine w/dye								
72146	Mri chest spine w/o dye								
72147	Mri chest spine w/dye								
72148	Mri lumbar spine w/o dye								
72149	Mri lumbar spine w/dye								
72156	Mri neck spine w/o & w/dye								
72157	Mri chest spine w/o & w/dye								
72158	Mri lumbar spine w/o & w/dye								
72159	Mr angio spine w/o & w/ dye								
72191	Ct angiography, pelv w/o & w/ dye								
72192	Ct pelvis w/o dye								
72193	Ct pelvis w/ dye								
72194	Ct pelvis w/o & w/ dye 								
72195	Mri pelvis w/o dye								
72196	Mri pelvis w/ dye								
72197	Mri pelvis w/o &w/ dye								
72198	Mri angio pelvis w/ or w/o dye								
73200	Ct upper extremity w/o dye								
73201	Ct upper extremity w/dye								
73202	Ct upper extremity w/o & w/dye								
73206	Ct angio upper extr w/o & w/dye								
73218	Mri upper extr w/o dye								
73219	Mri upper extr w/dye								
73220	Mri upper extremity w/o & w/dye								
73221	Mri joint upper extr w/o dye								
73222	Mri joint upper extr w/dye								
73223	Mri joint upper extr w/o & w/dye								
73225	Mr angio upr extr w/o & w/ dye								
73700	Ct lower extremity w/o dye								
73701	Ct lower extremity w/dye								
73702	Ct lower extremity w/o & w/dye								
73706	Ct angio lower ext w/o & w/dye								
73718	Mri lower extremity w/o dye								
73719	Mri lower extremity w/dye								
73720	Mri lower ext w/ & w/o dye								
73721	Mri joint of lwr extre w/o dye 								
73722	Mri joint of lwr extr w/dye								
73723	Mri joint of lwr extr w/o & w/dye								
73725	Mr angio lower ext w or w/o dye								
74150	Ct abdomen w/o dye								
74160	Ct abdomen w/ dye								
74170	Ct abdomen w/o & w/ dye								
74174	Ct angio abd & pelv w/o & w/dye								
74175	Ct angiography, abdom w/o & w/ dye								
74176	Ct abd & pelvis w/o contrast								
74177	Ct abdomen & pilvis w/ constrast								
74178	Ct abd & pelv 1+ section/regns								
74181	Mri abdomen w/o dye								
74182	Mri abdomen w/ dye								
74183	Mri abdomen w/o and w/ dye								
74185	Mri angio, abdom w/ or w/o dye								
74261	Ct colonography w/o dye								
74262	Ct colonography w/ dye								
75557	Cardiac mri for morph								
75559	Cardiac mri w/stress img								
75561	Cardiac mri for morph w/dye								
75563	Cardiac mri w/stress img & dye								
75571	Ct hrt w/o dye w/ca test								
75572	Ct hrt w/3d image								
75573	Ct hrt w/3d image, congen								
75574	Ct angio hrt w/3d image								
75635	Ct angio abdominal arteries								
76604	Us exam, chest, b-scan								
76700	Us exam, abdom, complete								
76705	Echo exam of abdomen								
76770	Us exam abdo back wall, comp								
76775	Us exam abdo back wall, lim								
76776	Us exam k transpl w/doppler								
76831	Echo exam, uterus								
76856	Us exam, pelvic, complete								
76857	Us exam, pelvic, limited								
76870	Us exam, scrotum								
77058	Mri, one breast								
77059	Mri, broth breasts								
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
									
